Patented Apr. 30, 1940 ,VUNITED STATES PATENTOFFICEYV MEANS AND METHOD OF CLOSING SURGICAL INCISIO-NS Carl E. Conn, Los Angeles, Calif. 'Application June s, 1936, Serial No. 84,120" 3 Claims (Grim- 335) This invention relates to suturation devices and methods of their use by which the sides of incisions may be supported in closed relation for prompt and effective cicatrization and effective healing thereof upon completion of a surgical operation.

At the conclusion of an abdominal operation, for instance, the walls of the incision are usually supported adjacent one another to permit the wound to heal by sutures of various well known types. Sutures of the prior art which do not allow for subsequent swelling of the tissues tend to cut and irritate the wound. The necessary time for healing is thus prolonged, during which the discomfort of the patient is increased and the resultant scar is often excessively large or deep, and occasionally completely opened, permitting extrusion of abdominal contents following excessive straining from vomiting or coughing.

It is also important that access to the incision be unrestricted to aid inspection and bathing of the wound; and that replacement of the dressing be facilitated, without disturbance of the sutures or of the healing process.

It is an important object of the present invention to provide a suturation device for resiliently supporting in closed position all or any portion of an incision and thereby prevent cutting of, or undue strain or constriction upon the tissues through which the suture passes.

Another object is to provide a wound closing suture assembly adapted to be suspended from skin surfaces adjacent the incision to resiliently 'maintain the walls thereof together, which en ables free accessto the wound for subsequent treatment and cleansing, and further presents a flat surface of small bulk to minimize the risk of displacement or strain by bedding or cloth- Another object is to provide a cushion to support suspension means for a suture, composed of resilient material which may be impregnated with antiseptics and adapted to absorb secretions which tend to flow from the depths of the wound along the suture to the skin surface.

Another object is the provision of a suture cradle to hold opposite walls of an incision together, which may be adapted to completely encircle the wound without construction of the deeper tissues by the addition of removable rubber bands or suture material tied across connecting the top of the cradle, said bands being useful in maintaining position of a surgical dressing on the surface of the wound. 1

Another object is the provision of a. method for the most effective and efiicient utilization of a device embodying the characteristics of the above-noted objects, which results in greater comfort to the patient, smaller scars, and speed in healing.

Other objects and advantages will be apparent to those of skill in this art upon an examination of the following descriptionread in the light of the accompanying drawing, in which Fig. l is a perspective view of a suture button of my invention;

Fig. 2 is a perspective view of the cushion hereof;

Fig. 3 is a somewhat diagrammatic view illustrative of the incised abdominal wall and overlyinglayers of muscular tissue and fat with my invention operatively applied thereto;

Fig; 4 is a plan view of the invention as shown in Fig. 3;

Referring to the drawing in detail, the numerals of which indicate similar parts throughout the several views; 5 and 6 designate, respectively,

- the outer layer of fat and an under layer of muscular tissue of a patient, separated and bound together by fascia 'l, which covers the abdominal wall 8.

A suture button 10 is provided comprising a flat disk having diametrically-disposed slots II at opposite sides of its center. A, central bar l2 separates the inner ends of said slots l l. Upon completion of the surgical operation, a silk suture l3,doubled in a curved needle (not shown), is hookedover the bar I 2 of the disk and. is

. threaded through the center of a circular sponge rubber cushion I 4. The needle is then passed through. the skin of the patient at one side of the incision, carrying the suture I3 downwardly through the outer layers 5 and 6, curving toward the incision at any depth desired, and then r is returned to the-surface at the opposite side re: I

of the wound. The sides .of the incision are then'drawn together, the tissue being sutured as indicated at I6.

The free end of the silk suture I3 is passed through another sponge rubbe'rcushion I1, and

is preferably at right angles to the incision to maintain alignment of opposite sides thereof,

An incision of, a surgical operation through the layers 5 and 6 and wall 8 is indicated at 9.

and to cooperate with the sutures H in supporting adjacent tissue while the wound is healing.

It will be obvious to those of skill in the art that the degree and direction of support of sutures l3 may be varied by altering the spaced relation with the incision of opposite reaches of the thread. A series of such cradles may be em ployed in the same manner, the number being influenced by the nature, location, length, or depth of the incision.

A surgical dressing 2!] covering the Wound between the disks may be firmly yet resiliently maintained in position by rubber or inelastic bands 2|, each of which is hooked at opposite sides to the silken suture at a point between the cushion l4 and disk It] and cushion I1 and disk l9. The bands 2| may be removed at will without disturbing the cradle, thus enabling cleans-v ing or treatment of the incision and replacement of the dressing.

As above noted, the cushion I! on which the discs 19 are supported is composed of sponge rubber of a size and a sufficiently absorbent quality to absorb secretions whichtend to flow from the depth of the wound through the passages formed by the needle, through which the sutures extend, to the skin surface. The cushions may be impregnated with any suitable medicaments or antiseptics which, upon compression of the cushions by the buttons incident to the swelling of the wound after the operation, will expel the medicament into the passages through which the sutures extend to treat the depths of the incision.

it will thus be seen that I have provided a suture adaptable to support in a U-shaped cradle incisions of any length or depth, carrying cushioning means to permit expansion of the tissues by swelling or flexing of the wound during move ment of the patient, thereby preventing excessive tension of the silk thread which might result in cutting of the flesh by either the thread or disk. The disks further provide a fiat surface, free of projections with which clothing of the patient or bedding may become entangled to tear or break the wound or displace the sutures or dressing.

It will be obvious that numerous changes may be made in the embodiment shown, particularly in the form of disk; that any well known suture material may be substituted for the silk thread described; that the number or particular spaced arrangement of the composite cradles may be varied to meet specific requirements, and that while the invention is described as applied to an abdominal incision, it will be apparent that the device is applicable to wounds of any similar nature at any part of the body-all without departing from the spirit of my invention.

What I claim and desire to secure by Letters Patent is:

1. The method of closing surgical incisions comprising attaching one end of a suture to a supporting button, passing the opposite end of the suture through a resilient cushion, passing the suture downwardly through the skin of the patient, at one side of the wound, thence through the incision and through the skin at the opposite side of the incision, passing the suture through a cushion and securing its end to a supporting button.

2. The method of supporting the ends of a U- shaped suture having its ends emerging from the skin of a patient at opposite sides of an incision consisting in passing the ends of the suture through cushions and securing the ends of the suture to buttons.

3. Ina wound closing device, a suture adapted to extend through an incision and protrude from the skin of a patient at opposite sides of the incision, buttons for attachment at each end of the suture, and a cushion for the support of each button.